Tendo Achilles TA Rupture - David Gordon July 2006

Management

Non-operative protocol

Cast immobilization, 'Functional' treatment

Operative

- Open - Kessler, Bunnel, box suture techniques

- Percutaneous - Ma and Griffith 8 (6 incisions), Webb & Bannister 7 (3 incisions)

Post-operative protocol

Cast Immobilization, functional treatment


Questions

Non-operative protocol

Open vs Percutaneous vs Non operative

Suture technique

Post operative protocol

Outcomes - Complications, re-rupture, return to work, return to sport


Complications

Major - Death, PE, DVT, skin slough, sinus, fistula, 2 nd op

Moderate - Delayed healing, granuloma, infection, sural n. injury

Minor - Adhesions

Review Summary

 

Management

Re-rupture

Wound Infection

Overall Comps

Open

1.4% 1

3% 2

4.3% 3

2.8% 5

14.6% 1

5% 2

19.6% 3

5.6% 6

6.7% 1

26.1% 3

30% 5

21% 6

Percutaneous

2.1% 3

3.7% 6

0% 3

0% 6

15.6 1

8.3% 3

9.7% 6

Non-op

10.7% 1

13% 2

11.7% 5

0.5% 1

4.0% 5

 

 

 

 

 

 

 

 

 

 

 

 

 

Non Operative & Post Operative Protocol - ‘Functional’ treatment, not conclusive, but a well established regime 3 :

Aircast FWB with 3 (1.5cm high) heel raises, removing 1 every 2/52 9




Rehabilitation Guide



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